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Simon Machado R, Mathias K, Joaquim L, Willig de Quadros R, Petronilho F, Tezza Rezin G. From diabetic hyperglycemia to cerebrovascular Damage: A narrative review. Brain Res 2023; 1821:148611. [PMID: 37793604 DOI: 10.1016/j.brainres.2023.148611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/04/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
Diabetes mellitus is a globally significant disease that can lead to systemic complications, particularly vascular damage, including cardiovascular and cerebrovascular diseases of relevance. The physiological changes resulting from the imbalance in blood glucose levels play a crucial role in initiating vascular endothelial damage. Elevated glucose levels can also penetrate the central nervous system, triggering diabetic encephalopathy characterized by oxidative damage to brain components and activation of alternative and neurotoxic pathways. This brain damage increases the risk of ischemic stroke, a leading cause of mortality worldwide and a major cause of disability among surviving patients. The aim of this review is to highlight important pathways related to hyperglycemic damage that extend to the brain and result in vascular dysfunction, ultimately leading to the occurrence of a stroke. Understanding how diabetes mellitus contributes to the development of ischemic stroke and its impact on patient outcomes is crucial for implementing therapeutic strategies that reduce the incidence of diabetes mellitus and its complications, ultimately decreasing morbidity and mortality associated with the disease.
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Affiliation(s)
- Richard Simon Machado
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil; Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Graduate Program in Health Sciences, Health Sciences Unit, University of South Santa Catarina, Tubarão, SC, Brazil.
| | - Khiany Mathias
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Larissa Joaquim
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Rafaella Willig de Quadros
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Fabricia Petronilho
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Gislaine Tezza Rezin
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Graduate Program in Health Sciences, Health Sciences Unit, University of South Santa Catarina, Tubarão, SC, Brazil
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2
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Draghici AE, Zahedi B, Taylor JA, Bouxsein ML, Yu EW. Vascular deficits contributing to skeletal fragility in type 1 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1272804. [PMID: 37867730 PMCID: PMC10587602 DOI: 10.3389/fcdhc.2023.1272804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023]
Abstract
Over 1 million Americans are currently living with T1D and improvements in diabetes management have increased the number of adults with T1D living into later decades of life. This growing population of older adults with diabetes is more susceptible to aging comorbidities, including both vascular disease and osteoporosis. Indeed, adults with T1D have a 2- to 3- fold higher risk of any fracture and up to 7-fold higher risk of hip fracture compared to those without diabetes. Recently, diabetes-related vascular deficits have emerged as potential risks factors for impaired bone blood flow and poor bone health and it has been hypothesized that there is a direct pathophysiologic link between vascular disease and skeletal outcomes in T1D. Indeed, microvascular disease (MVD), one of the most serious consequences of diabetes, has been linked to worse bone microarchitecture in older adults with T1D compared to their counterparts without MVD. The association between the presence of microvascular complications and compromised bone microarchitecture indicates the potential direct deleterious effect of vascular compromise, leading to abnormal skeletal blood flow, altered bone remodeling, and deficits in bone structure. In addition, vascular diabetic complications are characterized by increased vascular calcification, decreased arterial distensibility, and vascular remodeling with increased arterial stiffness and thickness of the vessel walls. These extensive alterations in vascular structure lead to impaired myogenic control and reduced nitric-oxide mediated vasodilation, compromising regulation of blood flow across almost all vascular beds and significantly restricting skeletal muscle blood flow seen in those with T1D. Vascular deficits in T1D may very well extend to bone, compromising skeletal blood flow control, and resulting in reduced blood flow to bone, thus negatively impacting bone health. Indeed, several animal and ex vivo human studies report that diabetes induces microvascular damage within bone are strongly correlated with diabetes disease severity and duration. In this review article, we will discuss the contribution of diabetes-induced vascular deficits to bone density, bone microarchitecture, and bone blood flow regulation, and review the potential contribution of vascular disease to skeletal fragility in T1D.
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Affiliation(s)
- Adina E. Draghici
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Cardiovascular Research Laboratory, Schoen Adams Research Institute at Spaulding Rehabilitation, Cambridge, MA, United States
| | - Bita Zahedi
- Endocrine Unit, Massachusetts General Hospital, Boston, MA, United States
| | - J. Andrew Taylor
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Cardiovascular Research Laboratory, Schoen Adams Research Institute at Spaulding Rehabilitation, Cambridge, MA, United States
| | - Mary L. Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Boston, MA, United States
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Elaine W. Yu
- Endocrine Unit, Massachusetts General Hospital, Boston, MA, United States
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3
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Topical Reappraisal of Molecular Pharmacological Approaches to Endothelial Dysfunction in Diabetes Mellitus Angiopathy. Curr Issues Mol Biol 2022; 44:3378-3397. [PMID: 36005129 PMCID: PMC9406839 DOI: 10.3390/cimb44080233] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022] Open
Abstract
Diabetes mellitus (DM) is a frequent medical problem, affecting more than 4% of the population in most countries. In the context of diabetes, the vascular endothelium can play a crucial pathophysiological role. If a healthy endothelium—which is a dynamic endocrine organ with autocrine and paracrine activity—regulates vascular tone and permeability and assures a proper balance between coagulation and fibrinolysis, and vasodilation and vasoconstriction, then, in contrast, a dysfunctional endothelium has received increasing attention as a potential contributor to the pathogenesis of vascular disease in diabetes. Hyperglycemia is indicated to be the major causative factor in the development of endothelial dysfunction. Furthermore, many shreds of evidence suggest that the progression of insulin resistance in type 2 diabetes is parallel to the advancement of endothelial dysfunction in atherosclerosis. To present the state-of-the-art data regarding endothelial dysfunction in diabetic micro- and macroangiopathy, we constructed this literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We interrogated five medical databases: Elsevier, PubMed, PMC, PEDro, and ISI Web of Science.
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Endothelial Dysfunction and Ischemia-Modified Albumin Levels in Males with Diabetic and Nondiabetic Erectile Dysfunction. DISEASE MARKERS 2022; 2022:3661822. [PMID: 35585936 PMCID: PMC9110139 DOI: 10.1155/2022/3661822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 01/07/2023]
Abstract
In this study, we aimed to determine endothelial dysfunction and ischemia-modified albumin (IMA) levels in patients diagnosed with erectile dysfunction (ED) and to examine the relationship between these and diabetes disease. 86 male patients (46 patients with diabetes, age:
and 40 patients with nondiabetes (control group), age:
) were included in the study. IMA, a new indicator of tissue ischemia and oxidative stress, was checked. Superoxide dismutase (SOD) activity, another oxidative stress indicator, was examined. Endothelin-1 (ET-1), one of the parameters of endothelial dysfunction, was measured. Additionally, endothelial function was evaluated with flow-mediated vasodilatation (FMD). Student’s
-test was used for statistical evaluation.
values less than 0.05 were considered statistically significant. SOD activity was significantly lower in the diabetic group than in the control group, and ET-1 was significantly higher (
). IMA was found to be significantly higher in the diabetic group than the control group (
). FMD was significantly lower in diabetic group compared to the control group (
). According to our findings, the co-occurrence of erectile dysfunction and diabetes demonstrates a complex condition that includes endothelial dysfunction, oxidative stress, and tissue ischemia. When the correlation of indicators, which are markers, was examined, the severity of the co-occurrence of diabetes and erectile dysfunction was again demonstrated.
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Kaushik A, Kapoor A, Dabadghao P, Khanna R, Kumar S, Garg N, Tewari S, Goel PK, Sinha A. Use of strain, strain rate, tissue velocity imaging, and endothelial function for early detection of cardiovascular involvement in young diabetics. Ann Pediatr Cardiol 2021; 14:1-9. [PMID: 33679055 PMCID: PMC7918008 DOI: 10.4103/apc.apc_158_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/31/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Subtle structural and functional changes may precede the onset of overt global left ventricular (LV) dysfunction. Data pertaining to tissue velocity imaging (TVI)and strain imaging to assess regional myocardial function and flow mediated vasodilatation are limited in young patients with diabetes. Materials: Conventional echocardiography, TVI parameters along with strain (S), and strain rate (SR) were measured in 50 young diabetics (15.16 ± 2.95 years, mean HBA1c 8.15 ± 1.37 g %) and 25 controls (15.60 ± 2.51 years). Flow-mediated dilation (FMD), nitrate--mediated dilatation (NMD), and carotid intima–media thickness were also assessed. Results: Conventional echocardiography parameters were similar in patients and controls; however, deceleration time of the mitral inflow velocity (early deceleration time) was significantly shorter in patients when compared with controls (149.06 ± 31.66 vs. 184.56 ± 19.27 ms, P =0.001). Patients had lower strain values at the basal lateral LV (21.39 ± 4.12 vs. 23.78 ± 2.02; P =0.001), mid-lateral LV (21.43 ± 4.27 vs. 23.17 ± 1.92 P =0.02), basal septum (20.59 ± 5.28 vs. 22.91 ± 2.00; P = 0.01), and midseptum (22.06 ± 4.75 vs. 24.10 ± 1.99; P = 0.01) as compared to controls. SR at the basal and midsegments of the lateral LV wall and at the basal septum was also significantly lower in diabetic patients. Diabetic children also had endothelial dysfunction with significantly lower FMD (8.36 ± 4.27 vs. 10.57 ± 4.12, P = 0.04). Conclusions: LV strain indices and flow--mediated dilatation are impaired in asymptomatic children and adolescents with type 1 diabetes mellitus despite absence of overt heart failure and normal ejection fraction. Early detection of subclinical regional myocardial dysfunction by deformation analysis including strain and strain rate may be useful in the asymptomatic diabetic population.
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Affiliation(s)
- Atul Kaushik
- Department of Cardiology, AIIMS, Jodhpur, Rajasthan, India
| | - Aditya Kapoor
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Preeti Dabadghao
- Department of Endocrinology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Roopali Khanna
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sudeep Kumar
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Naveen Garg
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Satyendra Tewari
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Pravin K Goel
- Department of Cardiology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Archana Sinha
- Department of Dietetics, SGPGIMS, Lucknow, Uttar Pradesh, India
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Jasser‐Nitsche H, Haidl H, Cvirn G, Pohl S, Gallistl S, Fröhlich‐Reiterer E, Schlagenhauf A. Increased tissue factor activity promotes thrombin generation at type 1 diabetes onset in children. Pediatr Diabetes 2020; 21:1210-1217. [PMID: 32691481 PMCID: PMC7589270 DOI: 10.1111/pedi.13086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE In type 1 diabetes (T1D), a prothrombotic status due to elevated coagulation factors coincides with metabolic derailment. In a previous study, we discovered altered thrombin generation profiles in children with T1D. These alterations are potentially most pronounced at T1D onset and ameliorated after insulin treatment. We tested this hypothesis in a longitudinal study, measuring thrombin generation together with coagulation parameters in children at T1D onset and during follow-up. MATERIALS AND METHODS Twenty-three children (12 female, age: 9.4 [2.7-17.3] years; median [range]) were tested at T1D onset and after long-term insulin treatment. Thrombin generation was measured using calibrated automated thrombography. Tissue factor (TF) activity and tissue factor pathway inhibitor (TFPI) activity were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS A procoagulant shift was observed in thrombin generation traces at T1D onset compared to follow-up (time to peak: 5.67 [4.11-7.67] min vs 6.39 [4.89-10.44] min, P < .001). These alterations at T1D onset coincided with increased TF activity (5.18 [0.01-12.97] pmol/L vs 2.67 [0.04-10.41] pmol/L, P < .05) and increased TFPI activity (0.051 [0.038-0.074] U/mL vs 0.035 [0.026-0.056] U/mL, P < .05). CONCLUSION The procoagulant shift in thrombin generation at T1D onset is a result of increased TF activity, but this effect is partially counterbalanced by increased TFPI levels. Elevated TF and TFPI levels hint to a fragile hemostatic balance at the endothelial lining of blood vessels. Additional prothrombotic stimuli may tip over this balance explaining the increased thrombotic risk of children with T1D.
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Affiliation(s)
- Hildegard Jasser‐Nitsche
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Harald Haidl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Gerhard Cvirn
- Otto Loewi Research Center, Physiological ChemistryMedical University of GrazGrazAustria
| | - Sina Pohl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Siegfried Gallistl
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Elke Fröhlich‐Reiterer
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
| | - Axel Schlagenhauf
- Department of Paediatrics and Adolescent Medicine, Division of General PaediatricsMedical University of GrazGrazAustria
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Arzhimatova GS, Hejlo TS, Novova NL, Suchkova OV. [Bulbar capillaroscopy and plethysmography for assessment of blood microcirculation and endothelium properties in type 1 diabetes]. Vestn Oftalmol 2019; 135:55-61. [PMID: 31215535 DOI: 10.17116/oftalma201913502155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To evaluate the properties of the microvasculature of bulbar conjunctiva and to assess the function of endothelium of the main arteries in type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS The study included 35 patients with T1DM and initial nonproliferative diabetic retinopathy (NPDR). The control group consisted of 30 subjects. In addition to standard ophthalmic examination, all participants underwent digital bulbar capillaroscopy (DBC), pulse wave velocity (PWV) test, and plethysmography for assessment of endothelium function. RESULTS According to DBC, in comparison to the control group, diabetic patients with even initial NPDR had disturbances of blood microcirculation manifested as increased average venous vessel width (p=0.04), reduced arterial capillary blood flow (p=0.02), increased blood sludging (p=0.001), and increased duration of blood stasis (p=0.03). Evaluation of vessel endothelium in T1DM patients with NPDR showed increased PWV (p=0.03). CONCLUSION Diabetic patients with NPDR showed marked changes of capillary blood flow alongside signs of endothelial dysfunction. The most significant change was increased venous vessel width.
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Affiliation(s)
- G Sh Arzhimatova
- City clinical hospital named after S.P. Botkin, Branch #1, Mamonovskiy per., 7, Moscow, Russian Federation, 123001
| | - T S Hejlo
- Center of therapeutic ophthalmology, 63/2, 1, Leninsky Pr., Moscow, Russian Federation, 119991
| | - N L Novova
- Center of therapeutic ophthalmology, 63/2, 1, Leninsky Pr., Moscow, Russian Federation, 119991
| | - O V Suchkova
- City clinical hospital named after S.P. Botkin, Branch #1, Mamonovskiy per., 7, Moscow, Russian Federation, 123001; Center of therapeutic ophthalmology, 63/2, 1, Leninsky Pr., Moscow, Russian Federation, 119991; Scientific Clinical Center of Russian Railways, 20 Chasovaya St., Moscow, Russian Federation, 125315
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Karavanaki K, Tsouvalas E, Vakaki M, Soldatou A, Tsentidis C, Kaparos G, Augoulea A, Alexandrou A, Lambrinoudaki Ι. Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction. J Pediatr Endocrinol Metab 2018; 31:1169-1177. [PMID: 30352039 DOI: 10.1515/jpem-2018-0147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/25/2018] [Indexed: 11/15/2022]
Abstract
Background Although carotid intima media thickness (CIMT) is an established marker of endothelial dysfunction, limited data exist on relative laboratory biomarkers in youngsters with type 1 diabetes mellitus (T1DM). Our aim was to study CIMT and the biomarkers of the osteoprotegerin (OPG)/RANKL system in young T1DM patients and controls, and also in subgroups of patients with increased risk for endothelial dysfunction, such as those with overweight/obesity, poor metabolic control or the presence of microalbuminuria. Methods CIMT and OPG/RANKL of 56 T1DM children and adolescents were compared to 28 healthy controls. Results Anthropometric, laboratory, CIMT and OPG/RANKL measurements were similar between patients and controls. Overweight/obese patients had greater CIMT than the normal weight ones (0.50 vs. 0.44 mm, p=0.001). Microalbuminuric patients had greater CIMT (0.49 vs. 0.44 mm, p=0.035) than the normoalbuminuric ones, with no difference in terms of OPG/RANKL. In the microalbuminuric group, OPG (r=-0.90, p=0.036) and RANKL (r=-0.92, p=0.024) were significantly negatively associated with CIMT. Following linear regression analysis, in the total patients group, microalbuminuria was the only factor significantly associated with CIMT (beta±SE: 0.050±0.021, p=0.035), body mass index (BMI)-z-scores were negatively associated with OPG (beta±SE: -0.25±0.12, p=0.05), while in the microalbuminuric group, CIMT was negatively associated with OPG (beta±SE: -0.070±0.019, p=0.036). During the forward stepwise procedure, microalbuminuria and age were the only variables negatively associated with RANKL (b=-0.334, p=0.034, b=-35.95, p=0.013, respectively). Conclusions In T1DM pediatric patients, overweight/obesity and microalbuminuria were associated with greater CIMT and with impaired OPG/RANKL levels, as biochemical indices of calcification of the atherosclerotic plaque.
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Affiliation(s)
- Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, Second Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Emmanouil Tsouvalas
- Diabetes and Metabolism Clinic, Second Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Marina Vakaki
- Radiology Department, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, Second Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Charalambos Tsentidis
- Diabetes and Metabolism Clinic, Second Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - George Kaparos
- Hormonal Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
| | - Ιrene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece
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Alman AC, Talton JW, Wadwa RP, Urbina EM, Dolan LM, Hamman RF, D'Agostino RB, Marcovina SM, Dabelea DM. Inflammation, adiposity, and progression of arterial stiffness in adolescents with type 1 diabetes: The SEARCH CVD Study. J Diabetes Complications 2018; 32:995-999. [PMID: 30209019 PMCID: PMC6174105 DOI: 10.1016/j.jdiacomp.2018.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/28/2017] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
AIMS We examined the association between inflammation and progression of arterial stiffness in a population of youth with type 1 diabetes (T1D). METHODS A total of 287 youth with T1D (median age 13 years) from SEARCH CVD, an ancillary study to the SEARCH for Diabetes in Youth, were included. Markers of inflammation (CRP, IL-6, fibrinogen, leptin, and adiponectin) and measures of pulse wave velocity (PWV) of the arm (PWV-R), trunk (PWV-T), and lower extremity (PWV-LE) were measured at baseline. Measures of PWV were repeated approximately five years later. RESULTS PWV-R (0.50 m/s), PWV-T (0.65 m/s), and PWV-LE (1.0 m/s) significantly increased over the follow-up (p < 0.001 for each). A significant interaction was found between waist circumference and fibrinogen (p = 0.036) on the progression of PWV-T, suggesting that fibrinogen is more strongly associated with PWV progression in lean participants. CONCLUSIONS Improved understanding of adiposity, inflammation, and functional changes in the vascular system in patients with T1D is crucial.
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Affiliation(s)
- Amy C Alman
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, USA.
| | - Jennifer W Talton
- Department of Biostatistical Sciences, Wake Forest School of Medicine, USA
| | - R Paul Wadwa
- Barbara Davis Center, University of Colorado Denver, USA
| | - Elaine M Urbina
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA
| | - Lawrence M Dolan
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA
| | - Richard F Hamman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, USA
| | - Ralph B D'Agostino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, USA
| | - Santica M Marcovina
- Department of Metabolism, Endocrinology and Nutrition, University of Washington, USA
| | - Dana M Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, USA
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Güneş H, Kıvrak T, Tatlısu M, Kaya H, Yılmaz MB. Relationship between endothelial dysfunction and microalbuminuria in familial Mediterranean fever. Eur J Rheumatol 2016; 3:61-64. [PMID: 27708973 PMCID: PMC5042232 DOI: 10.5152/eurjrheum.2016.15079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/07/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The aim of our study is to investigate the relationship between microalbuminuria and flow-mediated dilatation in familial Mediterranean fever (FMF) patients. MATERIAL AND METHODS In our study, there were two groups consisting of 54 patients who were out of the attack period (43 of whom had no microalbuminuria and 11 of whom had microalbuminuria) and 40 healthy controls (M/F: 12/28). RESULTS There was no statistically difference between patient and control groups'age (25.06±8.07, 22.89±6.00 years, respectively). Flow-mediated dilatation (FMD) percentages were significantly different between the three groups (p=0.01). It was observed that there was a correlation between microalbuminuria and FMD percentage. CONCLUSION Endothelial dysfunction and renal damage occurred as a result of low-grade chronic inflammation. Microalbuminuria, which is the indicator of renal damage and endothelial dysfunction, and FMD show that endothelial functions can be used in the following of early detection of renal damage and endothelial functions in FMF patients.
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Affiliation(s)
- Hakan Güneş
- Clinic of Cardiology, Sivas Numune Hospital, Sivas, Turkey
| | - Tarık Kıvrak
- Clinic of Cardiology, Sivas Numune Hospital, Sivas, Turkey
| | | | - Hakkı Kaya
- Department of Cardiology, Cumhuriyet University Hospital, Sivas, Turkey
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11
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Polat SB, Ugurlu N, Aslan N, Cuhaci N, Ersoy R, Cakir B. Evaluation of biochemical and clinical markers of endothelial dysfunction and their correlation with urinary albumin excretion in patients with type 1 diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:117-24. [PMID: 26886090 DOI: 10.1590/2359-3997000000116] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/28/2015] [Indexed: 11/22/2022]
Abstract
Objective Endothelial dysfunction (ED) plays an important role in the pathogenesis of diabetic nephropathy. The purpose of the study was to determine flow mediated endothelial dependent vasodilatation (FMD) measurements and serum soluble (s) endothelin-1 (ET-1), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM-1) levels in patients with type 1 diabetes mellitus (T1DM) with or without increased urinary albumin excretion (UAE) and compare them with the healthy controls. Subjects and methods Seventy three patients with T1DM were enrolled. Patients were divided into two subgroups according to microalbumin measurements in 24-hr urine collections. The diabetic patients without microalbuminuria (41 patients) were defined as Group I and those with microalbuminuria (32 patients) were defined as group II. A hundred age and sex matched healthy subjects participated as the control group (Group III). Serum sET-1, sICAM-1, sVCAM-1 levels and FMD measurements were determined in all participants. Results Median FMD measurement was significantly lower in the diabetic groups compared with the control group (6.6, 6.4 and 7.8% in Group I, II and III, respectively) (p < 0.05). FMD was negatively correlated with age (p = 0.042). Median serum sICAM-1 level was higher in the patient groups compared to the control group (p < 0.05). Median serum sVCAM-1 level was higher in the group of patients with increased albuminuria compared to the normoalbuinuric and the control group (p < 0.05). Serum sVCAM-1 level was found to be positively correlated with degree of urinary albumin excretion (p < 0.001). Conclusion We assume that sVCAM-1 may be used as a predictive marker for risk stratification for nephropathy development and progression.
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Affiliation(s)
- Sefika Burcak Polat
- Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Nagihan Ugurlu
- Department of Ophtalmology, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Nabi Aslan
- Department of Cardiology, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Neslihan Cuhaci
- Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Reyhan Ersoy
- Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Bekir Cakir
- Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey
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12
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Assar ME, Angulo J, Rodríguez-Mañas L. Diabetes and ageing-induced vascular inflammation. J Physiol 2015; 594:2125-46. [PMID: 26435167 DOI: 10.1113/jp270841] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/28/2015] [Indexed: 12/16/2022] Open
Abstract
Diabetes and the ageing process independently increase the risk for cardiovascular disease (CVD). Since incidence of diabetes increases as people get older, the diabetic older adults represent the largest population of diabetic subjects. This group of patients would potentially be threatened by the development of CVD related to both ageing and diabetes. The relationship between CVD, ageing and diabetes is explained by the negative impact of these conditions on vascular function. Functional and clinical evidence supports the role of vascular inflammation induced by the ageing process and by diabetes in vascular impairment and CVD. Inflammatory mechanisms in both aged and diabetic vasculature include pro-inflammatory cytokines, vascular hyperactivation of nuclear factor-кB, increased expression of cyclooxygenase and inducible nitric oxide synthase, imbalanced expression of pro/anti-inflammatory microRNAs, and dysfunctional stress-response systems (sirtuins, Nrf2). In contrast, there are scarce data regarding the interaction of these mechanisms when ageing and diabetes co-exist and its impact on vascular function. Older diabetic animals and humans display higher vascular impairment and CVD risk than those either aged or diabetic, suggesting that chronic low-grade inflammation in ageing creates a vascular environment favouring the mechanisms of vascular damage driven by diabetes. Further research is needed to determine the specific inflammatory mechanisms responsible for exacerbated vascular impairment in older diabetic subjects in order to design effective therapeutic interventions to minimize the impact of vascular inflammation. This would help to prevent or delay CVD and the specific clinical manifestations (cognitive decline, frailty and disability) promoted by diabetes-induced vascular impairment in the elderly.
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Affiliation(s)
- Mariam El Assar
- Instituto de Investigación Sanitaria del Hospital Universitario de Getafe, Getafe, Spain
| | - Javier Angulo
- Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Instituto de Investigación Sanitaria del Hospital Universitario de Getafe, Getafe, Spain.,Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
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Ultrastructure of Placenta of Gravidas with Gestational Diabetes Mellitus. Obstet Gynecol Int 2015; 2015:283124. [PMID: 26379710 PMCID: PMC4561319 DOI: 10.1155/2015/283124] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 07/15/2015] [Indexed: 12/03/2022] Open
Abstract
Objectives. Gestational diabetes mellitus (GDM) leads to an abnormal placental environment which may cause some structural alterations of placenta and affect placental development and function. In this study, the ultrastructural appearances of term placentas from women with GDM and normal pregnancy were meticulously compared. Materials and Methods. The placenta tissues of term birth from 10 women with GDM and 10 women with normal pregnancy were applied with the signed informed consent. The morphology of fetomaternal interface of placenta was examined using light microscopy (LM) and transmission electron microscopy (TEM). Results. On LM, the following morphological changes in villous tissues were found in the GDM placentas when compared with the control placentas: edematous stroma, apparent increase in the number of syncytial knots, and perivillous fibrin deposition. On TEM, the distinct ultrastructural alterations indicating the degeneration of terminal villi were found in the GDM placentas as follows: thickening of the basal membrane (BM) of vasculosyncytial membrane (VSM) and the VSM itself, significantly fewer or even absent syncytiotrophoblastic microvilli, swollen or completely destroyed mitochondria and endoplasmic reticulum, and syncytiotrophoblasts with multiple vacuoles. Conclusion. Ultrastructural differences exist between GDM and control placentas. The differences of placenta ultrastructure are likely responsible for the impairment of placental barrier and function in GDM.
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Blaslov K, Bulum T, Duvnjak L. The role of endothelial dysfunction driven by adipocitokines in the development and progression of microvascular complications in patients with type 1 and type 2 diabetes. Med Hypotheses 2015; 84:593-5. [DOI: 10.1016/j.mehy.2015.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 11/24/2022]
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15
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Sabri MR, Tavana EN, Ahmadi A, Hashemipour M. The effect of vitamin C on endothelial function of children with type 1 diabetes: an experimental study. Int J Prev Med 2014; 5:999-1004. [PMID: 25489448 PMCID: PMC4258680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/28/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Considering the importance of improvement of endothelial function in patients with type 1 diabetes mellitus (DM) and to prevent its related micro- and macro-vascular complications; in this study, the effect of vitamin C administration on improving endothelial function of children with type 1 diabetes was investigated. METHODS In this analytic-experimental study, children with type 1 DM aged 6-18 years and a group of healthy children enrolled. Vitamin C (250 mg/daily) administrated for the two studied groups for 1-month. Endothelial function evaluated by flow-mediated dilatation (FMD) and intima-media thickness (IMT) measurement using vascular Doppler ultrasonography, before and after trial. RESULTS In this study, 18 patients with type 1 diabetes (DM) and 19 normal children as the control group were studied. After vitamin C administration IMT reduced in all studied groups (P < 0.05). FMD increased in all studied groups, but it was significant only in the control group (P = 0.02 in the control group and P = 0.07 in patients with DM). Mean differences of IMT 2 - IMT 1, FMD 2 - FMD 1 and left ventricular (LV) mass 2 - LV mass 1 and blood pressure (BP) were not significantly different in two studied groups (P > 0.05). Mean differences of IMT 2 - IMT 1, FMD 2 - FMD 1, LV mass 2 - LV mass 1 and BP were not significantly different in patients with HbA1c ≤ 7 g/dl and those with HbA1c >7 g/dl and control group (P > 0.05). CONCLUSIONS The findings of the current study indicated that vitamin C may have a protective effect on endothelial dysfunction, but regarding its effectiveness among the high-risk population such as diabetic patients with and without appropriate glycemic control the study was not sufficiently powered due to its small sample size.
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Affiliation(s)
- Mohammad Reza Sabri
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Esfandiar Najafi Tavana
- Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Dr. Esfandiar Najafi Tavana, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Alireza Ahmadi
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Hashemipour
- Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Eltayeb AA, Ahmad FA, Sayed DM, Osama AM. Subclinical vascular endothelial dysfunctions and myocardial changes with type 1 diabetes mellitus in children and adolescents. Pediatr Cardiol 2014; 35:965-74. [PMID: 24595824 DOI: 10.1007/s00246-014-0883-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/05/2014] [Indexed: 01/11/2023]
Abstract
Vascular endothelial dysfunction, accelerated thickening of arterial intima, and changes in ventricular functions contribute to increased cardiovascular morbidity in type 1 diabetes mellitus (T1DM). This study aimed to investigate the functional-structural changes in the arteries and myocardium together with affection of highly sensitive C-reactive protein (hsCRP), circulating endothelial cells (CECs), and vitamin C levels in children with T1DM. Also, to test the association with early atherosclerotic changes. The study included 30 children with a diagnosis of T1DM and 30 healthy subjects matched by sex, age, and body mass index. Serum lipids, HbA1c, hsCRP, vitamin C, and CECs were detected. Corrected QT interval (QTc), cardiac dimensions, and left ventricular (LV) functions were assessed using conventional echocardiography. Noninvasive ultrasound was used to measure brachial artery flow-mediated dilation (FMD) responses and carotid intima-media thickness (IMT). The QTc interval was significantly higher in the diabetic patients than in the control subjects (P < 0.001). The findings showed LV diastolic dysfunction as reflected by significantly lower early peak flow velocity, decreased E/A ratio, increased early filling deceleration time (DcT), and prolonged isovolumic relaxation time (IVRT) (P < 0.001 for each). The children with diabetes had a significantly lower FMD response, increased IMT, lower vitamin C level, higher hsCRP, and higher CEC compared with the control subjects (P < 0.001 for each). A positive correlation between CEC and HbA1c was found (P = 0.004). An alteration in myocardial function and endothelial dysfunction may begin early with the association of early atherosclerotic changes. These changes are accelerated when glycemic control is poor. The authors recommend early and close observation of children with diabetes for any alterations in cardiac and vascular endothelial function. Vitamin C supplementation may reduce the risk of complications.
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Affiliation(s)
- Azza A Eltayeb
- Pediatric Department, PICU, Children University Hospital, Assiut University, B.O, 71111, Assiut, Egypt,
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17
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Ohsugi K, Sugawara H, Ebina K, Shiga K, Kikuchi N, Mori M, Yokota S. Comparison of brachial artery flow-mediated dilation in youth with type 1 and type 2 diabetes mellitus. J Diabetes Investig 2014; 5:615-20. [PMID: 25411631 PMCID: PMC4188121 DOI: 10.1111/jdi.12191] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/03/2013] [Accepted: 11/17/2013] [Indexed: 02/04/2023] Open
Abstract
Aims/Introduction Brachial artery flow‐mediated dilation (FMD) is a method of evaluating the function of vascular endothelial cells and is utilized for early diagnosis of atherosclerotic diseases. Only a few studies evaluated the risks for major vascular complications in youth with type 1 and 2 diabetes mellitus from the aspect of the early development of atherosclerosis. We studied whether there is a difference in vascular endothelial cell function between youth with type 1 and 2 diabetes mellitus. Materials and Methods We assessed %FMD of 24 patients with type 1 diabetes mellitus and 27 patients with type 2 diabetes mellitus aged 12–20 years along with glycated hemoglobin, lipid metabolism markers such as triglycerides, and inflammatory biomarkers such as total adiponectin levels in adolescent patients with type 1 or 2 diabetes mellitus. The significance of the difference in each factor between the type 1 and type 2 diabetes groups was assessed using Student's t‐test. Results The %FMD was significantly lower in patients with type 2 diabetes. The body mass index and blood pressure were significantly higher, and total and high‐molecular‐weight adiponectin levels were significantly lower in patients with type 2 diabetes. %FMD significantly correlated with systolic blood pressure. Conclusions The results suggest that youth with type 2 diabetes have more advanced damage of the vascular endothelium and therefore are at higher risk for major vascular complications. Therefore, monitoring the progression of atherosclerosis would also be beneficial in youth with diabetes mellitus, and measurement of FMD could be further warranted.
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Affiliation(s)
- Koji Ohsugi
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Hidenori Sugawara
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Kanako Ebina
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Kentaro Shiga
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Nobuyuki Kikuchi
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Masaaki Mori
- Department of Pediatrics Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Shumpei Yokota
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Kanagawa Japan
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Topical combinations aimed at treating microvascular dysfunction reduce allodynia in rat models of CRPS-I and neuropathic pain. THE JOURNAL OF PAIN 2013; 14:66-78. [PMID: 23273834 DOI: 10.1016/j.jpain.2012.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 09/13/2012] [Accepted: 10/05/2012] [Indexed: 11/22/2022]
Abstract
UNLABELLED Growing evidence indicates that various chronic pain syndromes exhibit tissue abnormalities caused by microvasculature dysfunction in the blood vessels of skin, muscle, or nerve. We tested whether topical combinations aimed at improving microvascular function would relieve allodynia in animal models of complex regional pain syndrome type I (CRPS-I) and neuropathic pain. We hypothesized that topical administration of either α(2)-adrenergic (α(2)A) receptor agonists or nitric oxide (NO) donors combined with either phosphodiesterase (PDE) or phosphatidic acid (PA) inhibitors would effectively reduce allodynia in these animal models of chronic pain. Single topical agents produced significant dose-dependent antiallodynic effects in rats with chronic postischemia pain, and the antiallodynic dose-response curves of PDE and PA inhibitors were shifted 2.5- to 10-fold leftward when combined with nonanalgesic doses of α(2)A receptor agonists or NO donors. Topical combinations also produced significant antiallodynic effects in rats with sciatic nerve injury, painful diabetic neuropathy, and chemotherapy-induced painful neuropathy. These effects were shown to be produced by a local action, lasted up to 6 hours after acute treatment, and did not produce tolerance over 15 days of chronic daily dosing. The present results support the hypothesis that allodynia in animal models of CRPS-I and neuropathic pain is effectively relieved by topical combinations of α(2)A or NO donors with PDE or PA inhibitors. This suggests that topical treatments aimed at improving microvascular function may reduce allodynia in patients with CRPS-I and neuropathic pain. PERSPECTIVE This article presents the synergistic antiallodynic effects of combinations of α(2)A or NO donors with PDE or PA inhibitors in animal models of CRPS-I and neuropathic pain. The data suggest that effective clinical treatment of chronic neuropathic pain may be achieved by therapies that alleviate microvascular dysfunction in affected areas.
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Hoffman RP, Dye AS, Bauer JA. Ascorbic acid blocks hyperglycemic impairment of endothelial function in adolescents with type 1 diabetes. Pediatr Diabetes 2012; 13:607-10. [PMID: 22925199 PMCID: PMC3505260 DOI: 10.1111/j.1399-5448.2012.00882.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 04/12/2012] [Accepted: 05/04/2012] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To determine whether acute ascorbic acid infusions alter the effect of hyperglycemia on endothelial function in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS The forearm blood flow (FBF) reactive hyperemic response to 5 min of upper arm occlusion was studied in eight adolescents with type 1 diabetes during euglycemic and hyperglycemic insulin clamp (40 mU/m2/min) with and without ascorbic acid infusion (3 mg/min). RESULTS The ratio of post- to preocclusion FBF decreased during hyperglycemia without ascorbic acid (p = 0.013), but did not change during hyperglycemia with ascorbic acid. The changes during hyperglycemia were different between the two studies (p = 0.038). Similar results were found when the percent change in forearm vascular resistance following occlusion was assessed. CONCLUSIONS These results indicate that antioxidant treatment with ascorbic acid blocks acute hyperglycemic impairment of endothelial function in adolescents with type 1 diabetes.
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Affiliation(s)
- Robert P. Hoffman
- Division of Pediatric Endocrinology, Metabolism and Diabetes Department of Pediatrics, The Clinical Research Center of The Ohio State University College of Medicine and Public Health
,Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
| | - Amanda S. Dye
- Division of Pediatric Endocrinology, Metabolism and Diabetes Department of Pediatrics, The Clinical Research Center of The Ohio State University College of Medicine and Public Health
| | - John A. Bauer
- Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
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Effect of ethanolic extract of seeds of Linum usitatissimum (Linn.) in hyperglycaemia associated ROS production in PBMNCs and pancreatic tissue of alloxan induced diabetic rats. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60088-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Hyperglycemia increases muscle blood flow and alters endothelial function in adolescents with type 1 diabetes. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:170380. [PMID: 22701470 PMCID: PMC3371684 DOI: 10.1155/2012/170380] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/09/2012] [Indexed: 02/04/2023]
Abstract
Alterations of blood flow and endothelial function precede development of complications in type 1 diabetes. The effects of hyperglycemia on vascular function in early type 1 diabetes are poorly understood. To investigate the effect of hyperglycemia on forearm vascular resistance (FVR) and endothelial function in adolescents with type 1 diabetes, FVR was measured before and after 5 minutes of upper arm arterial occlusion using venous occlusion plethysmography in (1) fasted state, (2) euglycemic state (~90 mg/dL; using 40 mU/m2/min insulin infusion), and (3) hyperglycemic state (~200 mg/dL) in 11 adolescents with type 1 diabetes. Endothelial function was assessed by the change in FVR following occlusion. Seven subjects returned for a repeat study with hyperglycemia replaced by euglycemia. Preocclusion FVR decreased from euglycemia to hyperglycemia (P = 0.003). Postocclusion fall in FVR during hyperglycemia was less than during euglycemia (P = 0.002). These findings were not reproduced when hyperglycemia was replaced with a second euglycemia. These results demonstrate that acute hyperglycemia causes vasodilation and alters endothelial function in adolescents with type 1 diabetes. In addition they have implications for future studies of endothelial function in type 1 diabetes and provide insight into the etiology of macrovascular and microvascular complications of type 1 diabetes.
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Yoon HJ, Jeong MH, Cho SH, Kim KH, Lee MG, Park KH, Sim DS, Yoon NS, Hong YJ, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC. Endothelial dysfunction and increased carotid intima-media thickness in the patients with slow coronary flow. J Korean Med Sci 2012; 27:614-8. [PMID: 22690091 PMCID: PMC3369446 DOI: 10.3346/jkms.2012.27.6.614] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 03/13/2012] [Indexed: 01/22/2023] Open
Abstract
Flow mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) have been a surrogate for early atherosclerosis. Slow coronary flow in a normal coronary angiogram is not a rare condition, but its pathogenesis remains unclear. A total of 85 patients with angina were evaluated of their brachial artery FMD, carotid IMT and conventional coronary angiography. Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count method. Group I was a control with normal coronary angiography (n = 41, 56.1 ± 8.0 yr) and group II was no significant coronary stenosis with slow flow (n = 44, 56.3 ± 10.0 yr). Diabetes was rare but dyslipidemia and family history were frequent in group II. Heart rate was higher in group II than in group I. White blood cells, especially monocytes and homocysteine were higher in group II. The FMD was significantly lower in group II than in group I. Elevated heart rate, dyslipidemia and low FMD were independently related with slow coronary flow in regression analysis. Therefore, endothelial dysfunction may be an earlier vascular phenomenon than increased carotid IMT in the patients with slow coronary flow.
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Affiliation(s)
- Hyun Ju Yoon
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Sook Hee Cho
- Department of Nursing, Nambu University, Gwangju, Korea
| | - Kye Hun Kim
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Min Goo Lee
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Keun Ho Park
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Nam Sik Yoon
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Jong Chun Park
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Center of Chonnam National University Hospital, Gwangju, Korea
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Nurmi L, Heikkilä HM, Vapaatalo H, Kovanen PT, Lindstedt KA. Downregulation of Bradykinin Type 2 Receptor Expression in Cardiac Endothelial Cells during Senescence. J Vasc Res 2012; 49:13-23. [DOI: 10.1159/000329615] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 05/20/2011] [Indexed: 11/19/2022] Open
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Value of carotid intimal–medial thickness as independent predictor of endothelial dysfunction in uremic patients. Egypt Heart J 2011. [DOI: 10.1016/j.ehj.2011.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Babar GS, Zidan H, Widlansky ME, Das E, Hoffmann RG, Daoud M, Alemzadeh R. Impaired endothelial function in preadolescent children with type 1 diabetes. Diabetes Care 2011; 34:681-5. [PMID: 21289230 PMCID: PMC3041207 DOI: 10.2337/dc10-2134] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We evaluated the prevalence of endothelial dysfunction as measured by flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (c-IMT) in relationship to vascular inflammatory biomarkers in preadolescent children with type 1 diabetes. RESEARCH DESIGN AND METHODS We studied 21 type 1 diabetic children (aged 8.3 ± 0.3 years with diabetes duration of 4.3 ± 0.4 years) and 15 group-matched healthy siblings (aged 7.6 ± 0.3 years). Fasting plasma glucose (FPG), lipid profile, HbA(1c), high-sensitivity C-reactive protein (hs-CRP), fibrinogen, homocysteine, and erythrocyte (red blood cell [RBC]) folate were evaluated in all subjects. Each subject underwent c-IMT and brachial artery FMD percentage (FMD%) measurements using high-resolution vascular ultrasound. RESULTS Type 1 diabetic children had higher FPG (173.4 ± 7.9 mg/dL vs. 81.40 ± 1.7 mg/dL; P < 0.0001), HbA(1c) (8.0 ± 0.2% vs. 5.0 ± 0.1%; P < 0.0001), and hs-CRP (1.8 ± 0.3 vs. 0.70 ± 0.2; P = 0.017) than control children without significant differences in BMI, homocysteine, and fibrinogen levels; RBC folate content; and c-IMT between the groups. Children with type 1 diabetes had lower FMD% than control children (7.1 ± 0.8% vs. 9.8 ± 1.1%; P = 0.04), whereas c-IMT did not differ between groups. CONCLUSIONS Preadolescent children with type 1 diabetes and mean diabetes duration of 4 years displayed evidence of low-intensity vascular inflammation and attenuated FMD measurements. These data suggest that endothelial dysfunction and systemic inflammation, known harbingers of future cardiovascular risk, are present even in preadolescent children.
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Affiliation(s)
- Ghufran S Babar
- Department of Pediatric Endocrinology, Children’s Mercy Hospital, Kansas City, Missouri, USA
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Giménez M, Gilabert R, Lara M, Conget I. Preclinical arterial disease in patients with type 1 diabetes without other major cardiovascular risk factors or micro-/ macrovascular disease. Diab Vasc Dis Res 2011; 8:5-11. [PMID: 21109602 DOI: 10.1177/1479164110388674] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers. Lower FMD percentages and greater cIMT/fIMT were observed in patients with T1D in comparison with controls (FMD 7.0 ± 3.1% vs. 9.6 ± 2.2%; p<0.005; cIMT 0.523 ± 0.091 mm vs. 0.471 ± 0.061 mm; p<0.05 and fIMT 0.512 ± 0.172 mm vs. 0.394 ± 0.061 mm; p<0.01, for patients and controls, respectively). T1D subjects in the highest tertile of cIMT were older than those in the lowest group (39.9 ± 9.5 vs. 29.6 ± 4.7 years; p<0.005) and had a longer duration of the disease (18.7 ± 5.4 years vs. 11.8 ± 6.4 years). The higher the cIMT tertile, the greater the fIMT (0.397 ± 0.114 mm vs. 0.431 ± 0.082 mm vs. 0.583 ± 0.197 mm; p<0.05). MAGE was negatively correlated to FMD (r=-0.328; p<0.05) and positively to cIMT (r=0.322; p<0.05). There were no differences between cIMT tertiles in terms of metabolic parameters or endothelial and inflammatory markers. Signals of preclinical atherosclerosis in T1D even in the absence of cardiovascular risk factors and micro- / macrovascular disease are reported. Our findings suggest that daily glucose instability could negatively impact vascular function and structure.
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Affiliation(s)
- Marga Giménez
- Endocrinology and Diabetes Unit, Hospital Clínic I Universitari, Bareclona, Spain
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Liu J, Wei S, Tian L, Yan L, Guo Q, Ma X. Effects of endomorphins on human umbilical vein endothelial cells under high glucose. Peptides 2011; 32:86-92. [PMID: 20970471 DOI: 10.1016/j.peptides.2010.09.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 09/27/2010] [Accepted: 09/27/2010] [Indexed: 12/19/2022]
Abstract
The endomorphin-1 (EM1) and endomorphin-2 (EM2) are endogenous opioid peptides, which modulate extensive bioactivities such as pain, cardiovascular responses, immunological responses and so on. The present study was undertaken to investigate the effects of EM1/EM2 on the primary cultured human umbilical vein endothelial cells (HUVECs) damaged by high glucose. PI AnnexinV-FITC detection was performed to evaluate the apoptosis rate. Levels of nitric oxide (NO) and nitric oxide synthase (NOS) activity were measured by the Griess reaction and the conversion of 3H-arginine to 3H-citrulline, respectively. Endothelin-1 (ET-1) was evaluated by the enzyme-linked immunosorbent assay (ELISA). Cell proliferation was determined by the MTT viability assay. mRNA expression of endothelial nitric oxide synthase (eNOS) and ET-1 were measured by real-time PCR. Our data showed that EM1/EM2 inhibited cell apoptosis. The high glucose induced increase in expression of NO, NOS and ET-1 were significantly attenuated by pretreatment with EM1/EM2 in a dose dependent manner. In addition, EM1/EM2 suppressed the mRNA eNOS and mRNA ET-1 expression in HUVECs under high glucose conditions. Naloxone, the nonselective opioid receptor antagonist, did not influence the mRNA eNOS expression when it was administrated on its own; but it could significantly antagonize the effects induced by EM1/EM2. Furthermore, in all assay systems, EM1 was more potent than EM2. The results suggest that EM1/EM2 have a beneficial effect in protecting against the endothelial dysfunction by high glucose in vitro, and these effects were mediated by the opioid receptors in HUVECs.
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Affiliation(s)
- Jing Liu
- Department of Endocrinology, the People's Hospital of Gansu Province, 204 Donggang West Road, Lanzhou 730000, PR China.
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Astaxanthin restores the enzymatic antioxidant profile in salivary gland of alloxan-induced diabetic rats. Arch Oral Biol 2010; 55:479-85. [PMID: 20510163 DOI: 10.1016/j.archoralbio.2010.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 04/01/2010] [Accepted: 04/29/2010] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the effect of astaxanthin on antioxidant parameters of salivary gland from diabetic rats. The hypothesis of the study was whether the supplementation of diabetic rats with astaxanthin might antagonize, or at least prevent, the defect in their antioxidative status. DESIGN Wistar rats (n=32) were divided in 4 groups: untreated control, treated control, untreated diabetic and treated diabetic rats. Astaxanthin (20mg/kg body weight) was administered daily by gavage for 30 days. On day 23, diabetes was induced by injection of alloxan (60 mg/kg body weight). After 7 days of diabetes induction, the rats were killed and submandibular and parotid removed. Superoxide dismutase (SOD), catalase, glutathione peroxidase and reductase activities and the content of thiol groups were determined. Data were compared by ANOVA and the Tukey test (p<0.05). RESULTS Diabetes caused a reduction of SOD, and thiol content and increase of catalase and glutathione peroxidase activities of submandibular gland whilst in the parotid gland diabetes caused an increase of thiol content and no effect in the antioxidant system. The astaxanthin restores the enzymatic activities in the salivary gland, however does not prevent its oxidative damage. CONCLUSION The submandibular gland presented more susceptibility to oxidative alterations induced by diabetes. Astaxanthin presented a positive effect on the oxidative protection of the salivary gland from diabetic rats.
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DiMeglio LA, Tosh A, Saha C, Estes M, Mund J, Mead LE, Lien I, Ingram DA, Haneline LS. Endothelial abnormalities in adolescents with type 1 diabetes: a biomarker for vascular sequelae? J Pediatr 2010; 157:540-6. [PMID: 20542287 PMCID: PMC4140170 DOI: 10.1016/j.jpeds.2010.04.050] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 03/22/2010] [Accepted: 04/26/2010] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To evaluate whether counts of circulating colony forming unit-endothelial cells (CFU-ECs), cells co-expressing CD34, CD133, and CD31 (CD34+CD133+CD31+), and CD34+CD45- cells are altered in adolescents with type 1 diabetes and if the changes in counts correlate with endothelial dysfunction. STUDY DESIGN Adolescents with diabetes (ages 18 to 22 years) and race- and sex-matched control subjects were studied. We assessed circulating CFU-ECs, using colony assays, and CD34+CD133+CD31+ and CD34+CD45- cells, using poly-chromatic flow cytometry. CFU-ECs and CD34+CD133+CD31+ are hematopoietic-derived progenitors that inversely correlate with cardiovascular risk in adults. CD34+CD45- cells are enriched for endothelial cells with robust vasculogenic potential. Vascular reactivity was tested by laser Doppler iontophoresis. RESULTS Subjects with diabetes had lower CD34+CD133+CD31+ cells, a trend toward reduced CFU-ECs, and increased CD34+CD45- cells compared with control subjects. Endothelium-dependent vasodilation was impaired in subjects with diabetes, which correlated with reductions in circulating CD34+CD133+CD31+ cells. CONCLUSIONS Long-term sequelae of type 1 diabetes include vasculopathies. Endothelial progenitor cells promote vascular health by facilitating endothelial integrity and function. Lower CD34+CD133+CD31+ cells may be a harbinger of future macrovascular disease risk. Higher circulating CD34+CD45- cells may reflect ongoing endothelial damage. These cells are potential biomarkers to guide therapeutic interventions to enhance endothelial function and to prevent progression to overt vascular disease.
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Affiliation(s)
- Linda A. DiMeglio
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Aneesh Tosh
- Divisions of Adolescent Medicine and Pediatric Endocrinology, University of Missouri School of Medicine, Columbia, MO
| | - Chandan Saha
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Myka Estes
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN
| | - Julie Mund
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN
| | - Laura E. Mead
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN
| | | | - David A. Ingram
- Herman B. Wells Center for Pediatric Research, Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Laura S. Haneline
- Herman B. Wells Center for Pediatric Research, Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN
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Pietro L, Daher S, Rudge MVC, Calderon IMP, Damasceno DC, Sinzato YK, Bandeira C, Bevilacqua E. Vascular endothelial growth factor (VEGF) and VEGF-receptor expression in placenta of hyperglycemic pregnant women. Placenta 2010; 31:770-80. [PMID: 20674013 DOI: 10.1016/j.placenta.2010.07.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/07/2010] [Accepted: 07/10/2010] [Indexed: 12/13/2022]
Abstract
Hyperglycemia occurs in a variety of conditions such as overt diabetes, gestational diabetes and mild hyperglycemia, all of which are generally defined based on the oral glucose tolerance test and glucose profiles. Whereas diabetes has received considerable attention in recent decades, few studies have examined the mechanisms of mild hyperglycemia and its associated disturbances. Mild gestational hyperglycemia is associated with macrosomia and a high risk of perinatal mortality. Morphologically, the placenta of these women is characterized by an increase in the number of terminal villi and capillaries, presumably as part of a compensatory mechanism to maintain homeostasis at the maternal-fetal interface. In this study, we analised the expression of VEGF and its receptors VEGFR-1 (Flt-1) and VEGFR-2 (KDR) in placentas from mildly hyperglycemic women. This expression was compared with that of normoglycemic women and women with gestational and overt diabetes. Immunohistochemistry revealed strong staining for VEGF and VEGFR-2 in vascular and trophoblastic cells of mildly hyperglycemic women, whereas the staining for VEGFR-1 was discrete and limited to the trophoblast. The pattern of VEGF and VEGF-receptor reactivity in placentas from women with overt diabetes was similar to that of normoglycemic women. In women with gestational diabetes, strong staining for VEGFR-1 was observed in vascular and trophoblastic cells whereas VEGF and VEGFR-2 were detected only in the trophoblast. The expression of these proteins was confirmed by western blotting, which revealed the presence of an additional band of 75 kDa. In the decidual compartment, only extravillous trophoblast reacted with all antibodies. Morphological analysis revealed collagen deposition around large arteries in all groups with altered glycemia. These findings indicate a placental response to altered glycemia that could have important consequences for the fetus. The change in the placental VEGF/VEGFR expression ratio in mild hyperglycemia may favor angiogenesis in placental tissue and could explain the hypercapillarization of villi seen in this gestational disturbance.
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Affiliation(s)
- L Pietro
- Department of Cell and Developmental Biology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil.
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Abi-Chahin TC, Hausen MDA, Mansano-Marques CM, Halfoun VLRDC. Microvascular reactivity in type 1 diabetics. ACTA ACUST UNITED AC 2010; 53:741-6. [PMID: 19893917 DOI: 10.1590/s0004-27302009000600008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 04/23/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate whether differences are present in microvascular response to the schemia induced by dynamic videocapillaroscopy (VCD), through analysis of the measured capillar transverse segment area (CTSA) in patients with type 1 diabetes mellitus (T1DM). METHODS The vascular reactivity of the CTSA was studied by VCD, using a reactive hyperemia test in 61 volunteers, being 31 healthy controls without diabetes family history (Group 1) and 30 patients with T1DM without complications (Group 2). The images were captured every two seconds, during reperfusion after one minute induced ischaemia, and they were analyzed by the program Studio Version 8 and Motic Image Plus. The pre-ischemia capillary transverse segment (basal area, BA), the maximum strain post-ischemia (maximum area, MA), and time to achieve it (MAt) were measured during reperfusion, and the increased area percentage (Ap) was estimated. RESULTS The mean differences between groups were evaluated by the t-test. The median comparisons between the groups were studied by the Mann-Whitney test. There was no difference in BA between the groups. The Ap was significantly lower among the diabetic patients, and there was a significant increase in the Mat among the patients of Group 2 when compared to Group 1. CONCLUSIONS These data suggest that type 1 diabetes provokes earlier endothelial dysfunction, before the onset of clinically detectable degenerative complications. The outcomes from these alterations need further studies.
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Nguyen TT, Islam FMA, Farouque HMO, Klein R, Klein BEK, Cotch MF, Herrington DM, Wong TY. Retinal vascular caliber and brachial flow-mediated dilation: the Multi-Ethnic Study of Atherosclerosis. Stroke 2010; 41:1343-8. [PMID: 20508189 DOI: 10.1161/strokeaha.110.581017] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Retinal vascular caliber changes have been shown to predict stroke, but the underlying mechanism of this association is unknown. We examined the relationship between retinal vascular caliber with brachial flow-mediated dilation (FMD), a measure of systemic endothelial function. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) is a population-based study of persons 45 to 84 years of age residing in 6 US communities free of clinical cardiovascular disease at baseline. Brachial FMD data were collected at baseline (July 2000 to June 2002), and retinal vascular caliber was measured from digital retinal photographs at the second examination, immediately after the first (August 2002 to January 2004). Data were available for 2851 participants for analysis. RESULTS The mean brachial FMD was 4.39+/-2.79%. After adjusting for age and gender, brachial FMD was reduced in persons with wider retinal venular caliber (changes in FMD -0.25, 95% CI, -0.36, - 0.13; P<0.001, per SD increase in venular caliber). This relationship persists after adjusting for systolic blood pressure, serum total cholesterol, use of lipid-lowering and antihypertensive medication, body mass index, current smoking status, and hemoglobinA(1C) (-0.18; 95% CI -0.30, - 0.06; P=0.004, per SD increase in venular caliber). Brachial FMD was not associated with retinal arteriolar caliber. CONCLUSIONS Persons with wider retinal venules have reduced brachial FMD, independent of other vascular risk factors. This suggests that retinal venular caliber, previously shown to predict stroke, may be a marker of underlying systemic endothelial dysfunction.
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Affiliation(s)
- Thanh T Nguyen
- Centre for Eye Research Australia, University of Melbourne, Australia
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Leite MF, Nicolau J. Sodium tungstate on some biochemical parameters of the parotid salivary gland of streptozotocin-induced diabetic rats: a short-term study. Biol Trace Elem Res 2009; 127:154-63. [PMID: 18810331 DOI: 10.1007/s12011-008-8233-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 09/01/2008] [Indexed: 12/26/2022]
Abstract
Several studies have shown the antidiabetic properties of sodium tungstate. In this study, we evaluated some biochemical parameters of the parotid salivary gland of streptozotocin-induced diabetic rats treated with sodium tungstate solution (2 mg/ml). The studied groups were: untreated control (UC), treated control (TC), untreated diabetic (UD), and treated diabetic (TD). After 2 and 6 weeks of treatment, parotid gland was removed and total protein and sialic acid (free and total) concentration and amylase and peroxidase activities were determined. Data were compared by variance analysis and Tukey test (p < 0.05). The sodium tungstate treatment modestly decreased the glycemia of streptozotocin-induced diabetic rats. At week 2 of the study, parotid gland of diabetic rats presented a reduction of total protein concentration (55%) and an increase of amylase (120%) and peroxidase (160%) activities, free (150%) and total (170%) sialic acid concentration. No alteration in the evaluated parameters at week 6 of the study was observed. Sodium tungstate presented no significant effect in parotid gland. Our results suggest that diabetes causes initial modification in biochemical composition of parotid. However, this gland showed a recovery capacity after 6 week of the experimental time. Sodium tungstate has no effect in peripheral tissues, such as salivary glands.
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Affiliation(s)
- Mariana Ferreira Leite
- Centro de Pesquisa em Biologia Oral, Faculdade de Odontologia da Universidade de São Paulo, Av Lineu Prestes, 2227, São Paulo, SP, Brazil, CEP 05508-000.
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